（《素问·通评虚实论》《奇病论》）
帝曰∶癫疾何如？（《素问·通评虚实论》）。岐伯曰∶脉搏大滑，久自已；脉小坚急，死不治。（搏大而滑为阳脉，阳盛气亦盛，故久
将自已。若小坚而急，则肝之真藏脉也，全失中和而无胃气，故死不治。）帝曰∶癫疾之脉，虚实何如？岐伯曰∶虚则可
治，实则死。（虚则柔缓，邪气微也，故生。实则弦急，邪气盛也，故死。）
帝曰∶人生而有病巅疾者，病名曰何？安所得之？（《素问·奇病论》。凡百病之生，必由外感内伤，人有初生者，未犯邪气，即有巅疾，故欲以明之。）岐伯曰∶病名
为胎病，此得之在母腹中时，其母有所大惊，气上而不下，精气并居，故令子发为巅疾也。（惊则气乱而逆，故气上不下。
气乱则精亦从之，故精气并及于胎，令子为巅痫疾也。愚按∶巅疾者，即癫痫也。本经巅、癫通用，于此节之义可见，
诸家释为顶巅者非。盖儿之初生，即有病癫痫者，今人呼为胎里疾者即此，未闻有胎病顶巅者也。凡诸篇有书巅字者，
当因此以辨其义。）
（《素问·举痛论》 附∶诸痛治法）
黄帝问曰∶余闻善言天者，必有验于人；善言古者，必有合于今；善言人者，必有厌于己。如此则道不惑而要数极，
所谓明明也。（天与人一理，其阴阳气数，无不相合，故善言天者必有验于人。古者今之鉴，欲察将来，须观既往，故善
言古者必有合于今。彼之有善，可以为法，彼之有不善，可以为戒，故善言人者必有厌于己。厌，足也，美也。明此三
者，尚何所不明哉？）今余问于夫子，令言而可知，视而可见，扪而可得，令验于己，如发蒙解惑，可得而闻乎？（发
蒙者，如去其蒙蔽也。扪音门。）岐伯再拜稽首对曰∶何道之问也？帝曰∶愿闻人之五脏卒痛，何气使然？（卒，猝同。）
岐伯对曰∶经脉流行不止，环周不休，寒气入经而稽迟，泣而不行，客于脉外则血少，客于脉中则气不通，故卒然而痛。
（泣音涩，下同。）帝曰∶其痛或卒然而止者，或痛甚不休者，或痛甚不可按者，或按之而痛止者，或按之无益者，或喘
动应手者，或心与背相引而痛者，或胁肋与少腹相引而痛者，或腹痛引阴股者，或痛宿昔而成积者，或卒然痛死不知人
少间复生者，或痛而呕者，或腹痛而后泄者，或痛而闭不通者，凡此诸痛，各不同形，别之奈何？（右卒痛证，凡十四
种，其候各异也。）岐伯曰∶寒气客于脉外则脉寒，脉寒则缩蜷，缩蜷则脉绌急，绌急则外引小络，故卒然而痛，得炅则
痛立止。（蜷，不伸也。绌，屈曲也。炅，热也。寒气客于脉外者，邪不甚深，卫气不得流通，则外引小络而卒然为痛，
故但得炅暖之气，其痛则立止也。蜷音拳。绌音屈。炅，居永切。）因重中于寒，则痛久矣。（重中于寒，则不易解散也。）
寒气客于经脉之中，与炅气相搏则脉满，满则痛而不可按也。（阳气行于脉中而寒袭之，则寒热相搏，留而不行，则邪实
于经，故脉满而痛，不可按也。）寒气稽留，炅气从上，则脉充大而血气乱，故痛甚不可按也。（炅气从上，阳主升也。
寒邪遏之，则脉充于内而血气乱，故其痛必甚。）寒气客于肠胃之间，膜原之下，血不得散，小络急引故痛，按之则血气
散，故按之痛止。（膜，筋膜也。原，肓之原也。义详下章。肠胃之间，膜原之下，皆有空虚之处，血不散而小络满，则
急引而痛，按之则寒气可散，小络可缓，故其痛止。非若经脉之无罅隙者，按之则愈实而愈痛也。《百病始生篇》曰∶其
着于肠胃之募原也，饱食则安，饥则痛。义与此通。）寒气客于挟脊之脉，则深按之不能及，故按之无益也。（挟脊者，
足太阳经也。其最深者，则伏冲伏膂之脉，故按之不能及其处。）寒气客于冲脉，冲脉起于关元，随腹直上，寒气客则脉
不通，脉不通则气因之，故喘动应手矣。（关元，任脉穴，在脐下三寸。冲脉起于胞中，即关元也。其脉并足少阴肾经，
夹脐上行，会于咽喉，而肾脉上连于肺，若寒气客之则脉不通，脉不通则气亦逆，故喘动应手也。）寒气客于背俞之脉则
脉泣，脉泣则血虚，血虚则痛，其俞注于心，故相引而痛，按之则热气至，热气至则痛止矣。（背俞，五脏俞也，皆足太
阳经穴。太阳之脉循膂当心入散，上出于项，故寒气客之，则脉涩血虚，为背与心相引而痛，因其俞注于心也。按之则
热至而痛止者，正以血虚故耳。）寒气客于厥阴之脉，厥阴之脉者，络阴器，系于肝，寒气客于脉中，则血泣脉急，故胁
肋与少腹相引痛矣。（肝经之脉循阴股入髦中，抵少腹，布胁肋也。）厥气客于阴股，寒气上及少腹，血泣在下相引，故
腹痛引阴股。（厥气，寒逆之气也。少腹阴股之间，乃足三阴冲脉之所由行也，寒气犯之，皆相引而痛。）寒气客于小肠
膜原之间，络血之中，血泣不得注于大经，血气稽留不得行，故宿昔而成积矣。（小肠为受盛之府，化物所出，若寒气客
其膜原络血之间，则血涩不行，故不得注于大经，稽留渐久，因成积也。）寒气客于五脏，厥逆上泄，阴气竭，阳气未入，
故卒然痛死不知人，气复反则生矣。（寒伤脏气，则气不得降而厥逆上泄，乃致真阴暴竭，阳气未能遽入，故卒然痛死，
必待脏气复反则生矣。）寒气客于肠胃，厥逆上出，故痛而呕也。（肠胃，言六腑也。水谷之在六腑，必自上而下，乃其
顺也；若寒气客之，则逆而上出，故为痛为呕。）寒气客于小肠，小肠不得成聚，故后泄腹痛矣。（小肠为丙火之腑，而
寒邪胜之，则阳气不化，水谷不得停留，故为后泄腹痛。）热气留于小肠，肠中痛，瘅热焦渴，则坚干不得出，故痛而闭
不通矣。（热留小肠，是阳藏阳病也，故为瘅热焦渴、坚干痛闭之疾。愚按∶后世治痛之法，有曰痛无补法者，有曰通则
不痛痛则不通者，有曰痛随利减者，人相传诵，皆以此为不易之法，凡是痛证无不执而用之。不知痛而闭者。固可通之，
如本节云热结小肠、闭而不通之类是也。痛而泄者，不可通也，如上节云寒客小肠、后泄腹痛之类是也。观王荆公解痛
利二字曰∶治法云∶诸痛为实，痛随利减。世俗以利为下也。假令痛在表者，实也；痛在里者，实也；痛在血气者，亦
实也。故在表者，汗之则愈；在里者，下之则愈；在血气者，散之行之则愈。岂可以利为下乎？宜作通字训则可。此说
甚善，已得治实之法矣；然痛证亦有虚实，治法亦有补泻，其辨之之法，不可不详。凡痛而胀闭者，多实，不胀不闭者
多虚。痛而拒按者为实，可按者为虚。喜寒者多实，爱热者多虚。饱而甚者多实，饥而甚者多虚。脉实气粗者多实，脉
虚气少者多虚。新病壮年者多实，愈攻愈剧者多虚。痛在经者脉多弦大，痛在脏者脉多沉微。必兼脉证而察之，则虚实
自有明辨，实者可利，虚者亦可利乎？不当利而利之，则为害不浅。故凡治表虚而痛者，阳不足也，非温经不可；里虚
而痛者，阴不足也，非养营不可。上虚而痛者，心脾受伤也，非补中不可；下虚而痛者，脱泄亡阴也，非速救脾肾、温
补命门不可。夫以温补而治痛者，古人非不多也，惟近代薛立斋、汪石山辈尤得之。奈何明似丹溪，而亦曰诸痛不可补
气，局人意见，岂良法哉？）帝曰∶所谓言而可知者也，视而可见奈何？（欲察色以知病也。）岐伯曰∶五脏六腑固尽有
部，（义详脉色类三十二。）视其五色，黄赤为热，白为寒，青黑为痛，此所谓视而可见者也。（黄赤色者，火动于经，故
为热。白色者，阳气衰微，血不上荣，故为寒。青黑色者，血凝气滞，故为痛。）帝曰∶扪而可得奈何？（以手按摸也。）
岐伯曰∶视其主病之脉，坚而血及陷下者，皆可扪而得也。帝曰∶善。（主病之脉，病所在也。脉坚者，邪之聚也。血留
者，络必盛而起也。陷下者，血气不足，多阴候也。凡是者，皆可摸而得之。）
黄帝问道：癫疾的症状是怎样的？岐伯回答说：如果脉搏表现为大而滑，病程较长时疾病会自然痊愈；如果脉搏细小、坚硬且急迫，则属于死证，无法治愈。（脉搏大而滑属于阳脉，说明阳气旺盛，气机也盛，所以经过较长时间后疾病会自行好转。如果脉象细小坚硬而急迫，则是肝脏的真脏脉显现，完全失去了中和之气以及胃气的滋养，所以会导致死亡且无法治疗。）
黄帝又问：癫疾的脉象，虚证和实证各有什么表现？岐伯回答说：虚证可以治疗，实证则难以救治。（虚证表现为脉象柔和缓慢，说明邪气轻微，所以有生机。实证表现为脉象弦硬急迫，说明邪气亢盛，所以会导致死亡。）
黄帝问：人生下来就患有巅顶疾病的，这叫什么病名？是怎么得的呢？（《素问·奇病论》指出：各种疾病的发生，必然由外感或内伤引起。人有刚出生时就患病的情况，此时尚未接触邪气，却已有巅疾，因此想要弄明白其中的原因。）岐伯回答说：这种病名叫胎病，这是在母亲腹中时获得的。当时母亲受到过巨大的惊吓，导致气机上逆而不能下行，精气随之并聚于上，因此使胎儿发为巅疾。（惊骇会导致气机紊乱而逆乱，所以气上逆而不下降。气机紊乱则精气也随之逆行，精气并及于胎儿，致使孩子患上癫痫之疾。我按语认为：巅疾就是癫痫。本经中“巅”和“癫”字通用，从这一节的含义可以看出，各家解释为头顶部位的错误。因为婴儿刚出生就有癫痫病史的，现在人称为“胎里疾”，没听说过有先天性的头顶部位疾病的。凡是各篇中有写“巅”字的，应当据此来辨别其含义。）
（出自《素问·举痛论》，附：各种疼痛的治疗方法）
黄帝问道：我听说善于谈论天道的人，一定能在人体上找到验证；善于谈论古代的事，一定符合现在的情况；善于谈论别人的事，一定能引以为戒反省自己。如果能这样，那么医道就不会迷惑，而且能掌握要领和规律，这就是所谓的明智。（天与人的道理是一致的，阴阳气数没有不相合的，所以善于谈论天道的人一定能在人体上得到验证。古代是现在的借鉴，想要观察未来，必须回顾过去，所以善于谈论古代的事一定符合现在。别人的优点可以作为效法的榜样，别人的缺点可以作为警戒，所以善于谈论别人的一定能让自己感到满足和美好。明白了这三点，还有什么不明白的呢？）现在我向夫子请教，希望能做到言语可理解，观察可见知，触摸可得晓，让我在自身得到验证，就像揭开蒙蔽、消除困惑一样，能够听您讲讲吗？（“发蒙”意为去除蒙蔽。“扪”音门。）
岐伯拜了两拜，叩头行礼后回答说：您问的是哪方面的道理呢？
黄帝说：我想听听人的五脏突然疼痛，是什么气造成的？（“卒”同“猝”，意为突然。）
岐伯回答说：经脉中的气血流行不止，循环周身不停息。寒气侵入经脉后运行迟缓，凝涩而不流通。寒气客居在脉外，则血液减少；寒气客居在脉中，则气机不通畅，所以会突然发生疼痛。（“泣”音涩，以下同。）
黄帝问：那种疼痛有的突然停止，有的疼痛剧烈不止，有的疼痛剧烈不能按压，有的按压后疼痛停止，有的按压后无效，有的按压时感觉跳动应手，有的心口与背部相互牵引疼痛，有的胁肋部与小腹部相互牵引疼痛，有的腹痛牵引到大腿内侧，有的疼痛日久形成积块，有的突然剧痛昏死不知人事，片刻后又苏醒，有的疼痛伴有呕吐，有的腹痛随后腹泻，有的疼痛伴有大便闭塞不通。以上这些疼痛，形态各不相同，如何区分它们呢？（上述卒痛证候共有十四种，症状表现各异。）
岐伯回答说：寒气客居在脉外，则经脉受寒，经脉受寒则收缩卷曲，收缩卷曲则脉络拘急，脉络拘急则向外牵引细小的络脉，所以突然发生疼痛，遇到温热则疼痛立刻停止。（蜷，指不伸展。绌，指屈曲。炅，指热。寒气客居在脉外，邪气不是很深，卫气不能流通，从而向外牵引小络而突然疼痛，所以只要得到温热的空气，疼痛就会立即停止。蜷音拳。绌音屈。炅，居永切。）如果再次遭受寒邪侵袭，疼痛就会持久。（再次中寒，则不易解散。）
寒气客居在经脉之中，与热气相搏结，则脉道充盈胀满，胀满则疼痛且不能按压。（阳气行于脉中，寒气袭击它，则寒热相互搏结，停留而不运行，导致邪气实于经脉，所以脉道充盈而疼痛，不能按压。）寒气滞留，热气从上而来，则脉道充大，血气紊乱，所以疼痛剧烈且不能按压。（热气从上而来，因为阳主升。寒邪遏制它，则脉道在内充盈而血气紊乱，所以疼痛必定很严重。）
寒气客居在肠胃之间，膜原之下，血液不能散行，小络脉紧急牵引所以疼痛，按压后血气散开，所以按压后疼痛停止。（膜，指筋膜。原，指肓之原。含义详见下一章。肠胃之间，膜原之下，都是空虚之处，血液不散而小络脉充盈，则紧急牵引而疼痛，按压后寒气可散，小络脉可舒缓，所以疼痛停止。不像经脉那样没有缝隙，按压后会更加充实而更痛。《百病始生篇》说：病邪附着在肠胃的募原处，吃饱饭则安适，饥饿时则疼痛。义理与此相通。）
寒气客居在夹脊的经脉，则深按达不到病所，所以按压无效。（夹脊处，是足太阳膀胱经。其中最深的是伏冲脉和伏膂脉，所以按压不能触及病处。）
寒气客居在冲脉，冲脉起于关元穴，沿腹部直上，寒气客居则脉道不通，脉道不通则气机随之逆乱，所以会出现喘动应手的现象。（关元，任脉穴位，在脐下三寸。冲脉起于胞中，即关元处。其脉并行足少阴肾经，夹脐上行，会于咽喉，而肾脉上连于肺，若寒气客居于此，则脉道不通，脉道不通则气也逆乱，所以出现喘动应手。）
寒气客居在背俞脉，则脉道凝涩，脉道凝涩则血虚，血虚则疼痛，背俞脉注于心，所以心与背部相互牵引疼痛，按压后热气到达，热气到达则疼痛停止。（背俞，指五脏的俞穴，都是足太阳膀胱经的穴位。太阳经脉循行脊柱当心入散，向上出于项部，所以寒气客居于此，则脉涩血虚，导致背与心相互牵引疼痛，因为背俞脉注于心。按压后热气到达而疼痛停止，正是因为血虚的缘故。）
寒气客居在厥阴脉，厥阴脉联络阴器，系属于肝，寒气客居在脉中，则血液凝涩，脉道紧急，所以胁肋与小腹部相互牵引疼痛。（肝经的脉循行阴股进入阴毛中，抵少腹，布散于胁肋。）
厥逆之气客居在阴股，寒气上行波及少腹，血液凝涩在下部相互牵引，所以腹痛牵引大腿内侧。（厥气，指寒逆之气。少腹和阴股之间，是足三阴经和冲脉通行的地方，寒气侵犯此处，都会相互牵引而痛。）
寒气客居在小肠膜原之间，络脉血液中，血液凝涩不能注入大经脉，血气稽留不能运行，所以日久形成积块。（小肠是受盛之腑，是化物之所出，若寒气客居在膜原络血之间，则血液涩滞不行，所以不能注入大经脉，稽留时间渐久，因而形成积块。）
寒气客居在五脏，导致厥逆之气上泄，阴气竭绝，阳气未能入内，所以突然剧痛昏死不知人事，待气机回复则生。（寒气损伤脏气，则气不得降而厥逆上泄，导致真阴暴竭，阳气未能迅速入内，所以突然剧痛昏死，必须等待脏气回复才能生存。）
寒气客居在肠胃，导致厥逆之气上出，所以疼痛且呕吐。（肠胃，指六腑。水谷在六腑中，必须自上而下运行，这才是顺行；若寒气客居其中，则逆而上出，所以产生疼痛和呕吐。）
寒气客居在小肠，小肠不能正常积聚食物，所以随后腹泻且腹痛。（小肠属丙火之腑，若寒邪胜过它，则阳气不化，水谷不能停留，所以导致腹泻和腹痛。）
热气留在小肠，肠中疼痛，湿热焦渴，则大便坚干排出困难，所以疼痛且大便闭塞不通。（热留小肠，这是阳脏患阳病，所以出现湿热焦渴、大便坚干疼痛闭塞的疾病。我按语认为：后世治疗疼痛的方法，有人说“痛无补法”，有人说“通则不痛，痛则不通”，还有人说“痛随利减”，人们互相传诵，都将其视为不可改变的方法，凡是疼痛病症都固执地运用。不知道疼痛伴便秘的，固然可以通下，如本节所说热结小肠、闭而不通之类。但疼痛伴腹泻的，不可以通下，如上节所说寒客小肠、后泄腹痛之类。看王荆公对“痛”、“利”二字的解释曰：治法云：诸痛为实，痛随利减。世俗把“利”理解为泻下。假如痛在体表，属实；痛在体内，属实；痛在血气，也属实。所以在表的，发汗则愈；在里的，攻下则愈；在血气的，消散行气则愈。怎么能把“利”仅仅理解为泻下呢？应该解释为“通”字才可。这个说法很好，已经得到了治疗实证的方法；然而疼痛病症也有虚实之分，治疗方法也有补泻之别，辨别的方法不可不详细。凡是疼痛且胀满闭塞的多属实证，不胀不闭的多属虚证。疼痛拒按的为实证，可按的为虚证。喜冷的多属实证，喜热的多属虚证。饱食后加重的多属实证，饥饿时加重的多属虚证。脉实气粗的多属实证，脉虚气少的多属虚证。新病壮年多属实证，越攻伐病情越重的多属虚证。痛在经络的脉多弦大，痛在脏腑的脉多沉微。必须结合脉象和症状来考察，则虚实自然有明确分辨，实证可以用通利法，虚证也可以用通利法吗？不应当用通利法而用了，则危害不小。所以凡是治疗表虚而痛的，是阳气不足，非温经不可；里虚而痛的，是阴血不足，非养营不可；上虚而痛的，是心脾受伤，非补中气不可；下虚而痛的，是脱泄亡阴，非速救脾肾、温补命门不可。用温补法治疼痛的，古人并非不多，只有近代的薛立斋、汪石山等人尤其深得此法。为何明代看似推崇丹溪，却也说诸痛不可补气，局促之见，难道是良法吗？）
黄帝说：所谓言语可理解的，是指什么？
岐伯回答说：五脏六腑都有对应的部位，（含义详见脉色类第三十二。）观察它们的五色，黄色和赤色主热，白色主寒，青色和黑色主痛，这就是所谓观察可见的。（黄赤色，是因为火动于经脉，所以主热。白色，是因为阳气衰微，血液不能上荣，所以主寒。青黑色，是因为血凝气滞，所以主痛。）
黄帝说：所谓触摸可得到的，是指什么？（用手按摸。）
岐伯回答说：观察主病的脉象，脉象坚实且有瘀血，或者脉象陷下的，都可以通过触摸得知。
黄帝说：好。（主病的脉，即病变所在的脉位。脉象坚实的，是邪气聚集的表现。血液留滞的，络脉必然盛大而起。脉象陷下的，是血气不足，多表现为阴证。凡是这些情况，都可以通过摸触得知。）
(From *Suwen: Tongping Xushi Lun* and *Qibing Lun*)
The Yellow Emperor asked: What are the manifestations of dian disease (epilepsy)? Qibo replied: If the pulse is large and slippery, the disease will recover spontaneously after a long period; if the pulse is small, firm, and rapid, it indicates a fatal condition that cannot be treated. (A large and slippery pulse belongs to Yang pulses, indicating abundant Yang Qi and vigorous Qi mechanism, so the disease will improve naturally over time. If the pulse is small, firm, and rapid, it manifests as the Zang organ's true pulse [Zhen Zang Mai], completely losing the harmonious Qi and Stomach Qi [Wei Qi], leading to death.)
The Yellow Emperor asked further: Regarding dian disease, what are the differences between deficiency and excess patterns? Qibo replied: Deficiency patterns can be treated, whereas excess patterns are difficult to cure. (Deficiency presents with a soft and slow pulse, indicating mild pathogenic factors, thus suggesting vitality. Excess presents with a wiry, hard, and rapid pulse, indicating rampant pathogenic factors, leading to death.)
The Yellow Emperor asked: A person is born with dian disease affecting the vertex. What is this disease called, and how is it acquired? (*Suwen: Qibing Lun* states: All diseases arise from external invasions or internal injuries. However, some individuals suffer from dian disease at birth before encountering pathogens, so we seek to understand the cause.) Qibo replied: This disease is called "Tai Bing" (fetal disease). It is acquired while in the mother's womb when the mother suffers from severe fright. Fright causes Qi to ascend and fail to descend, causing Essence and Qi to congregate upwards, thereby causing the fetus to develop dian disease. (Fright disrupts Qi mechanism, causing rebellion and ascent. Disrupted Qi leads Essence to follow, affecting the fetus and causing epilepsy. Note: Dian disease refers to epilepsy. In the classic text, "Dian" [vertex] and "Dian" [epilepsy] are used interchangeably. Interpreting it solely as "vertex" is incorrect. Infants born with epilepsy are now called "congenital epilepsy," but there is no such thing as a congenital "vertex disease." The character "Dian" in other chapters should be interpreted accordingly.)
(From *Suwen: Jutong Lun*, Appendix: Treatment Methods for Various Pains)
The Yellow Emperor asked: I have heard that those who speak well of Heaven must find verification in humanity; those who speak well of antiquity must align with the present; and those who speak well of others must find reflections in themselves. By doing so, one's understanding of the Dao remains clear and precise, which is called wisdom. (Heaven and humanity share the same principles; Yin-Yang and numerical laws correspond perfectly. Thus, speaking of Heaven verifies in humanity. Antiquity serves as a mirror for the present; observing the past helps predict the future. Others' virtues serve as models, and their faults as warnings. Understanding these three aspects brings clarity.) Now, I ask you, Master, to explain things that can be known through words, seen through observation, and felt through palpation, allowing me to verify them in myself, like lifting a veil or resolving confusion. ("Fa Meng" means removing obscurity. "Men" is pronounced 'men'.)
Qibo bowed twice and kowtowed, replying: What aspect of the Dao do you inquire about?
The Yellow Emperor said: I wish to hear about sudden pain in the five Zang organs. What Qi causes this? ("Cu" is synonymous with "Zu," meaning sudden.)
Qibo replied: The flow of Qi and Blood in the meridians never ceases, circulating endlessly. When Cold Qi enters the meridians, its flow slows and stagnates. If Cold lodges outside the vessels, Blood becomes deficient; if it lodges inside, Qi becomes obstructed, resulting in sudden pain. ("Qi" is pronounced 'se', meaning stagnant/astringent.)
The Yellow Emperor asked: Pain may cease suddenly, persist severely, be intolerable to pressure, relieved by pressure, unaffected by pressure, feel pulsating under pressure, radiate between the heart and back, radiate between the hypochondrium and lower abdomen, radiate from the abdomen to the inner thigh, form masses over time, cause sudden fainting with recovery later, accompany vomiting, accompany diarrhea, or accompany constipation. These pains vary in form. How should they be differentiated? (There are fourteen types of sudden pain listed above, each with distinct symptoms.)
Qibo replied: When Cold lodges outside the vessels, the vessels become cold, contract, and cramp, pulling on collateral vessels, causing sudden pain. Heat relieves this immediately. (Quan means not extending; Chu means bending; Jiong means heat. Cold outside vessels is shallow; Wei Qi cannot circulate freely, pulling collaterals. Heat resolves it. Quan sounds like 'quan'; Chu sounds like 'qu'; Jiong is pronounced 'jiong'.) If re-exposed to Cold, pain persists. (Repeated Cold invasion is hard to resolve.)
When Cold lodges within the vessels and combats Warmth, the vessels become full, causing severe pain unrelieved by pressure. (Yang Qi moves in vessels; Cold attacks, causing Cold-Heat combat. Pathogen stays, filling vessels, causing pain.) If Cold lingers and Warmth rises from above, vessels swell, Blood and Qi become chaotic, causing severe pain. (Warmth rises due to Yang nature. Cold blocks it, swelling vessels internally and disrupting Qi/Blood.)
When Cold lodges between the intestines/stomach and the membrane source (Mo Yuan), Blood cannot disperse, and small collaterals tense, causing pain. Pressure disperses Qi/Blood, relieving pain. (Membrane refers to fascia; Yuan refers to the origin of Huang. Intestines/stomach area has void spaces. Blood stasis fills small collaterals, causing tension. Pressure dissipates Cold and relaxes collaterals. Unlike solid vessels where pressure worsens pain. *Baibing Shisheng Pian* notes: Pathogens at Mo Yuan cause pain when hungry, relief when full.)
When Cold lodges in the paravertebral vessels, deep pressure cannot reach it, so palpation is ineffective. (Paravertebral region is Foot-Taiyang Bladder Meridian. Deepest parts are Fu Chong and Fu Lv vessels, inaccessible by palpation.)
When Cold lodges in the Chong Vessel, which originates at Guanyuan and ascends straight up the abdomen, obstruction occurs. Obstruction causes Qi rebellion, resulting in pulsation felt under the hand. (Guanyuan is Ren-4, 3 cun below umbilicus. Chong Vessel starts in uterus/Guanyuan, runs alongside Kidney Meridian, meets throat, connects to Lung. Cold causes obstruction and Qi rebellion.)
When Cold lodges in the Back-Shu vessels, vessels stagnate, Blood becomes deficient, causing pain. Since Shu points connect to the Heart, pain radiates between back and heart. Heat from palpation relieves pain. (Back-Shu points are Taiyang meridian points. Taiyang channel runs along spine to heart. Cold causes stagnation/deficiency, linking back and heart. Palpation generates heat, relieving deficiency-pain.)
When Cold lodges in the Jueyin vessel, which connects to genitalia and ties to the Liver, Blood stagnates and vessels tighten, causing radiating pain between hypochondrium and lower abdomen. (Liver channel runs through inner thigh to genitals, reaches lower abdomen, spreads to hypochondrium.)
Jue Qi (Cold-rebellious Qi) lodges in the inner thigh, Cold ascends to lower abdomen, Blood stagnates below, causing radiating pain from abdomen to inner thigh. (Jue Qi is Cold-rebellious Qi. Lower abdomen/thigh is pathway for Foot-Yin and Chong vessels. Cold causes radiating pain.)
When Cold lodges in Small Intestine membrane/collateral blood, Blood stagnates and cannot enter major vessels. Qi/Blood stay stagnant, forming masses over time. (Small Intestine receives and transforms. Cold in membranes/collaterals causes stasis, preventing entry into major vessels, eventually forming masses.)
When Cold lodges in the Five Zang, causing rebellious upward leakage, Yin exhausts, Yang fails to enter, causing sudden fainting/pain. Recovery depends on Qi returning. (Cold damages Zang Qi, causing upward rebellion, exhausting True Yin. Yang cannot enter quickly. Survival requires Qi restoration.)
When Cold lodges in intestines/stomach, causing rebellious upward emission, pain and vomiting occur. (Six Fu organs move downward. Cold causes upward rebellion, leading to pain/vomiting.)
When Cold lodges in Small Intestine, it cannot accumulate food, causing diarrhea and abdominal pain. (Small Intestine is Bing-Fire. Cold defeats Fire, failing to transform fluids/food, causing diarrhea/pain.)
When Heat remains in Small Intestine, intestinal pain, intense thirst, and dry stool occur, causing pain and constipation. (Heat in Small Intestine is Yang-disease-in-Yang. Causes thirst/dryness/constipation. Note: Later theories say "No tonification for pain," "Unblocked means no pain," "Pain decreases with purgation." These are often applied rigidly. Constipation allows purgation (Heat binding). Diarrhea prohibits it (Cold invading). Wang Anshi explained "Li" as "Tong" (unblocking/opening), not just purging. Surface pain needs sweating; interior pain needs purging; Qi/Blood pain needs dispersing. Pain has deficiency/excess. Distension/obstruction suggests excess; lack thereof suggests deficiency. Rejection of pressure suggests excess; acceptance suggests deficiency. Preference for cold suggests excess; preference for heat suggests deficiency. Worsening after eating suggests excess; worsening when hungry suggests excess. Strong pulse/rough breath suggests excess; weak pulse/faint breath suggests deficiency. New illness/youth suggests excess; worsening with attack suggests deficiency. Channel pain shows wiry/large pulse; Zang pain shows deep/faint pulse. Differentiate by pulse/symptoms. Excess can be purged; can deficiency be purged? Improper purging harms. Table-deficiency pain needs warming channels; Interior-deficiency pain needs nourishing Ying; Upper-deficiency (Heart/Spleen) needs tonifying Middle; Lower-deficiency (leakage/Yin loss) needs saving Spleen/Kidney and warming Mingmen. Ancient masters like Xue Lizhai and Wang Shishan mastered warm-tonification for pain. Why did Danyang followers reject tonification? Such limited views are not good methods.)
The Yellow Emperor asked: What does "known through words" mean?
Qibo replied: The Five Zang and Six Fu have specific locations. Observing the Five Colors reveals pathology: Yellow/Red indicates Heat; White indicates Cold; Blue/Black indicates Pain. This is "visible through observation." (Yellow/Red shows Fire moving in channels = Heat. White shows Yang deficiency/Blood failure to nourish = Cold. Blue/Black shows Blood stasis/Qi stagnation = Pain.)
The Yellow Emperor asked: What does "obtainable through palpation" mean? (Palpating with hands.)
Qibo replied: Observe the pulse governing the disease. Firm pulses indicate pathogen accumulation; stagnant Blood indicates distended collaterals; sunken pulses indicate Qi/Blood deficiency (Yin signs). All these can be detected by palpation. (Governing pulse locates disease. Firmness indicates pathogen gathering. Stagnant Blood causes collateral prominence. Sunken pulses indicate deficiency. All detectable by touch.)
The Yellow Emperor said: Excellent.